Keep pol­i­tics out of key pub­lic services and en­hance over­sight

The “dis­cov­ery” by Nairobi Gover­nor Mike Sonko re­cently of the bod­ies of 12 in­fants “hid­den” in boxes at Pumwani Ma­ter­nity Hos­pi­tal is a good ex­am­ple of why pol­i­tics should be delinked from key sec­tors such as health.

Com­ments were made that it was a public­ity stunt — and a foul one a such — all for po­lit­i­cal pop­ulist gain. In­deed, such in­ci­dents tend to only pro­vide photo ops for po­lit­i­cal lead­ers who have very lit­tle to do with the ad­vance­ment of such an im­por­tant sec­tor.

Politi­cians’ aim is to use health­care as a car­rot and stick to ad­vance their agenda. Time and again, we have heard how health­care played a huge role in po­lit­i­cal ral­lies when used as bait for votes.

But health­care is not a po­lit­i­cal but hu­man rights is­sue; it is a ser­vice that needs to be pro­vided as a mat­ter of course. It forms part of oblig­a­tory services that we all need and the State has a le­gal duty to pro­vide.

The ex­tra­di­tion of Gil­bert Deya, the key sus­pect, from the United King­dom to face charges of child traf­fick­ing took more than 10 years.

Then, Pumwani should have put in place wa­ter­tight se­cu­rity mea­sures to avoid a re­peat of such a heartrend­ing in­ci­dent. But here we are again, talk­ing about its mis­man­age­ment and baby traf­fick­ing and swap­ping!

The gov­ern­ment has re­acted quickly by send­ing in a team to in­ves­ti­gate the se­ri­ous breaches at Pumwani. How­ever, we should not be stand­ing at the point of in­ves­ti­gat­ing se­ri­ous mal­prac­tices at the same hos­pi­tal twice.

An over­haul of sys­tems at the hos­pi­tal after the first in­ci­dent could have en­sured no such ef­forts and re­sources would need to be spent on an­other in­ves­ti­ga­tion. The money should have gone into fund­ing the hos­pi­tal in­stead.

The man­ner in which the bod­ies of the in­fants were han­dled undig­ni­fied them and their fam­i­lies. How­ever, to lis­ten to the clin­i­cians say­ing there is no mor­tu­ary at the hos­pi­tal makes one won­der whether the man­age­ment knows that its pri­or­ity is to pro­tect the dig­nity of pa­tients, whether dead or alive.

Nearly a cen­tury since it was built, we should have ad­dressed such glar­ing gl­itches by build­ing a mor­tu­ary or two.

Tip of the ice­berg

Pumwani is just a tip of the ice­berg in how much in­dig­nity pa­tients suf­fer at most pub­lic hos­pi­tals. Poor treat­ment en­cap­su­lates the dis­re­gard the hos­pi­tals have for them.

We con­stantly read about our lead­ers con­va­lesc­ing in pri­vate hos­pi­tals here and abroad. Then dis­turb­ing pic­tures emerge of bod­ies dumped on mor­tu­ary floors in pub­lic hos­pi­tals with no re­gard for their dig­nity.

At many other hos­pi­tals, pa­tients are shown sleep­ing on the floor or shar­ing a tiny rick­ety bed. Yet oth­ers have no win­dows to shield pa­tients from the el­e­ments. Those with res­pi­ra­tory prob­lems such as pneu­mo­nia and TB are ex­posed to the cold fur­ther.

Just as we did with the po­lice ser­vice, time is ripe to con­sider hav­ing an in­de­pen­dent over­sight com­mis­sion with leg­isla­tive pow­ers to look into the af­fairs of pa­tients. It should have the author­ity to in­spect hos­pi­tal fa­cil­i­ties pe­ri­od­i­cally to en­sure that stan­dards are main­tained.

Kenya Med­i­cal Prac­ti­tion­ers and Den­tists Board is there to over­see the wel­fare of clin­i­cians. There is a need to have a third eye that would en­sure the hos­pi­tal en­vi­ron­ment is fit for both pa­tients and clin­i­cians.

The health over­sight com­mit­tees at both the Se­nate and the Na­tional As­sem­bly come late into crises and are run by politi­cians. I be­lieve they also easily run the risk of be­ing com­pro­mised. We wit­nessed it with the re­cent claims of med­i­cal neg­li­gence at Keny­atta Na­tional Hos­pi­tal, where politi­cians took tribal lines to pro­tect the CEO in­stead of be­ing con­cerned with pa­tients’ wel­fare.

The main role of a ‘Health­care Com­mis­sion’ would be to en­sure qual­ity and safety. That would help to min­imise the level of neg­li­gence are wit­ness­ing in the pub­lic hos­pi­tals by mit­i­gat­ing drug short­ages and lack of equip­ment and per­son­nel.

Es­sen­tially, their main role would be to raise the red flag when­ever a hos­pi­tal is found want­ing in its duty of care.

We now have, for the first time, the com­pre­hen­sive Health Act of 2017 that of­fers rights and pro­tec­tion to pa­tients and guid­ance to the State.

Cru­cially, given the level of cor­rup­tion re­ported in the health sec­tor, it is time we re­turned health­care to the na­tional gov­ern­ment to seal the loop­holes for cor­rup­tion.

Graft has de­volved with pol­i­tics and the only way to save pa­tients from fur­ther harm is to cen­tralise the work of the health sec­tor, which would make it eas­ier to man­age and au­dit. It will also pro­vide for a uni­form stan­dard of care across all the hos­pi­tals.